![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1176 to 1200 of 1242. Go back in thread:
Posted by Palbella on January 23, 2004, at 18:57:27
In reply to Re: Strattera--just for depression????-Jack Smith, posted by nmk on January 28, 2003, at 15:32:06
My son was taking Strattera and we took him off of it. We were not seeing any positive results for school. He was however more sociable. He has ADD and also has depression. I've read more post talking about opening the caps? I didn't know you could...?? I'm beginning to think he was on way to high a dose much too fast. Started on 40milligrams then 60 and would eventually go to 80 mgs. He's 12 years old and weighs 175 approx. The Zoloft he's on works very well for him but he still needs something more for the ADD. I'm thinking i might try him back on Strattera but open the cap and divide it. Anyone have more info on this subject? Thanks *S*
Posted by LightShifter on January 24, 2004, at 14:12:57
In reply to Re: Straterra » jcbikermom, posted by Palbella on January 23, 2004, at 18:42:01
The only person who knows if its "too much" or "too little" is the person who is EXPERIENCING the drug. No matter what any doctor may think, we all work dirrerently.
As I posted here before, the weight charts are a very poor way to start dosing people. Start low (say 10 mgs. and work up SLOWLY as necessary). For most people, 40 mg is way too much from what I've heard.
...Dan
> > My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
>
>
> How much does your son weigh? They told me my son which is 12 would end up taking 80 milligrams a day. He weighs 175 lbs and 60 milligrams seemed too much and didnt help him with school at all. Seem to make things worse.
>
Posted by Ragesgal on January 24, 2004, at 14:15:53
In reply to Re: Straterra, posted by LightShifter on January 24, 2004, at 14:12:57
OK.....I have had to switch to taking my 40mgs at night(bed) when I take my Seraquel (also makes me tired) so that I fall asleep and stay asleep. When I was taking it in the am at the 40mg dose, it was making me tired for those first three days. So far so good as far as taking at night with my Seraquel (mood stabliizer).
Posted by Palbella on January 24, 2004, at 15:19:19
In reply to Re: Straterra, posted by LightShifter on January 24, 2004, at 14:12:57
> The only person who knows if its "too much" or "too little" is the person who is EXPERIENCING the drug. No matter what any doctor may think, we all work dirrerently.
>
> As I posted here before, the weight charts are a very poor way to start dosing people. Start low (say 10 mgs. and work up SLOWLY as necessary). For most people, 40 mg is way too much from what I've heard.
>
> ...Dan
>
>
>
> > > My son is 11 years old and started taking 18mg a little over a week ago. The Dr. wanted to up the dose to 2 pills after 1 week. That was too much. He was sleepy and wouldn't wake up. I changed the dose to 25mg and that seems to be working. The Drs. always want to go by the weight chart and that's usually too high a dose.
> >
> >
> > How much does your son weigh? They told me my son which is 12 would end up taking 80 milligrams a day. He weighs 175 lbs and 60 milligrams seemed too much and didnt help him with school at all. Seem to make things worse.
> >
>
>I read about opening the caps and dividing....I wasn't aware you could open those. Is it true..If so i'll try less for him. Any info anyone??
Posted by Mid-Life Crisis on January 26, 2004, at 18:36:05
In reply to Re: Im 15 too, Midlife Crisis, what works for me » Mid-Life Crisis, posted by imjustme on January 17, 2004, at 21:24:55
That's great that you've found a combination of medication that works great for you, imjustme. My son will be switching to a different doctor soon, so maybe I'll suggest he try Adderall and Strattera together. (His grades don't seem to be responding to anything he's tried so far.)
As for your question about not being able to open up to your friends, it might be that you have been teased about being "different" in the past (many of us with ADHD were teased by other kids while growing up) and now you have a problem trusting your friends with your thoughts and feelings? I'm just guessing.
Someone else wrote and suggested you try getting off the medication. This person probably does not have ADHD and doesn't realize how difficult it can be to function in school wihout meds. I remember going through elementary school in the 1950's (with no meds, of course) and never knowing what we were talking about when the teacher called on me. So if your meds help you, don't feel you "should" try to get off them just because some people feel you should. That is a decision that belongs only to you, your parents and doctor.
Posted by LightShifter on January 26, 2004, at 21:15:50
In reply to Re: Straterra, posted by Palbella on January 24, 2004, at 15:19:19
> I read about opening the caps and dividing....I wasn't aware you could open those. Is it true..If so i'll try less for him. Any info anyone??
>
Yes. You can open up and split the capsules. I do myself. I open the 40 mg. caps and split into 2 or 3 equal piles and put them back into empty capsules which I buy at the health food store. I think you can also get them from your pharmacist but they might be more expensive. You may also have some vitamins laying around you'll never use that you can empty and put the Strattera in....Dan
Posted by jlawr on February 3, 2004, at 23:39:19
In reply to Re: Straterra, posted by Ragesgal on January 18, 2004, at 22:34:25
I am on day two of strattera (40mg). I am 24, male and have ADD aswell as depression. I am also taking lexapro (10mg), which I have been on for two weeks. The only side effect that I have really noticed would be the "zombie effect." I am not sure whether to blame this on the strattera or the lexapro. I have been overly tired and had maor loss of energy since I started the lexapro and it has gotten worse with the strattera. I will just have to give it time. I am going to switch to taking my pills at night rater than in the AM.
Posted by dazed on February 4, 2004, at 12:00:20
In reply to New to Straterra, posted by jlawr on February 3, 2004, at 23:39:19
I had zombie effect on Straterra too, although I was a bit happier in terms of mood.
It did othing for my ADD, however, some friends think it's straight from heaven.
Posted by kirick on February 5, 2004, at 18:58:09
In reply to Re: Straterra - No other takers? » zenclear, posted by kdg on May 18, 2003, at 0:44:50
My 6 yr. old son has been on Strattera for 5 weeks. He has just started to show some signs of improvement. I do like that he eats and does not get headaches. It has not helped with some of hyperness. He can't sit in his chair in school. Does anyone know about taking other medications for the hyperactivity?
Posted by Siraris on February 5, 2004, at 21:04:49
In reply to Re: Straterra working- but son still fidgets, posted by kirick on February 5, 2004, at 18:58:09
Everyone is different, so I would suggest consulting your p-doc.
I have been tapering up on Strattera for the past 4-5 weeks. I am at 60 MG now. I notice around mid afternoon, about 2 hours before I usually take my dose, I start bouncing my legs really fast like I am about to take off. Don't know what it is, but I'm not that worried. Other then that, it works great!
Posted by aviolet on February 7, 2004, at 18:34:06
In reply to Re: Strattera for Inattentive ADD ?, posted by polarber on December 27, 2003, at 13:14:51
Hey Dreaman,
Just wondering how you were doing on Strattera. I was just diagnosed as ADD-inattentive in my last year of law school and my doctor prescribed Strattera. I was a bit disappointed because I would like to start Ritalin. I was started on a starter pack of 18mg and have now moved up to 25mg and will soon move up to 40mg. So far I haven't noticed any positive effects :-( only the common negative side effects of dry mouth and constipation. I've only been on it for a week and a half so I guess its too early to tell.
Just wondering how others with ADD inattentive were doing on Straterra?
Posted by Dreaman on February 8, 2004, at 0:39:21
In reply to Re: Strattera for Inattentive ADD ?, posted by aviolet on February 7, 2004, at 18:34:06
Hello aviolet
I have been off of the stratt for a while now. Basically what happended is that it wasn't all that effective for me. I only took it for about 5 weeks and probably not at a high enough dose (30mg). But the thing that made me decide it probably would not work out for me was a lessening of its effectiveness even when I increased the dose. The meds main positive effects were to keep me awake during the day. Also in the beginning it slightly improved my motivation, but it wasnt much help with my inability to focus and my mental sluggishness. Ritalin was much more effective for these until it pooped out. I am pretty sure my problem is my dopamine system not my neuroepinephrine(strattera works on this).
If the stratt doesnt work out and you have similar symptoms to me you might want to look into an MAOI called selegiline. It has worked reasonably well for me since I started on it. Otherwize just go with ritalin.
*Dreaman
Posted by micro on February 9, 2004, at 9:07:07
In reply to Re: Straterra working- but son still fidgets, posted by kirick on February 5, 2004, at 18:58:09
> My 6 yr. old son has been on Strattera for 5 weeks. He has just started to show some signs of improvement. I do like that he eats and does not get headaches. It has not helped with some of hyperness. He can't sit in his chair in school. Does anyone know about taking other medications for the hyperactivity?
Hello,
Please purchase the followimg texts- Healing Add By Daniel Amen M.D., Driven to Distraction by Hallowell, M.D. and Ratey, M.D. as well as Answers to Distraction by these to authors. After reading them, You will be able to help your son in many different ways. Good Reading! Regards. Micro
P.S. There are too many meds and combinations to discuss here so go to www.amenclinic.com and request a copy of Add: Guide for Primary care Physicians. It has an algorithm for the medicating of add patients. [the July issue of Primary Psychiatry vol. 5 no.7, 1998]
Posted by liquidchakra on February 11, 2004, at 14:46:59
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
I am on 25 mg on day 7 right now, and although I have gotten surprising results so far, the side effects are still somewhat annoying (Although they are slowly getting better)
I've noticed 3 distinct stages after I take the pill in the morning around 7. From about 7:15 to 9:30 I am in NA rush mode, and get rather pleasant tingles on my skin, but often a strong sense of vertigo. I am very focused on my work, and do everything methodically and slowly in this state
From about 9:30 to 12 I'm in 'Oh my god is this going to give me a heart attack' mode. Pulse is high, vertigo is replaced by a splitting sinus headache and hot flashes, as well as a seemingly irregular heartbeat. I say seemingly, as I can feel it beating oddly in my chest, but when I hold my hand over it, it is beating normally, albeit a bit stronger. Around this time I start to get rushes of anxiety, but I can tell that it is simply my NA pumping (Flight or fight anxiety is the best way to describe it)
Maybe that has to do with food, since lunch is at 12, but after 12 I feel for lack of a better word...normal. Concentration is fine, I'm not tired, and everything is just great. My ideas flow better, my anxiety is almost non existent, and an odd feeling of Zen seems to descend on me. I don’t feel any irregular heartbeats either, which is a relief.
I'm taking is slowly just because of the heart problems (I was supposed to be up to 40 mg by now, but I am waiting until Sunday to do that now. Do these ever go completely away?
Posted by Ashlea on February 19, 2004, at 10:36:35
In reply to Strattera and splitting caps?, posted by Palbella on January 23, 2004, at 18:57:27
I have a 5 year old on Strattera. He can not/will not swallow the capsule so I started opening the pill and putting it in chocolate milk. I called Eli Lilly and of course they read their script and tell you that opening the pill is not advised and it was never tested that way. My doctor said their would be no problem in opening it, but that it has a very bitter taste and can cause a burning sensation in the mouth. So far, the milk seems to coat any burning and my son has not complained at all about it. I do know that my son is taking 25 mg dosage. Maybe you can request the 25 mg capsule instead of the 40 mg or 60 mg. Anyway, Good Luck...
Posted by Forest Gump on March 12, 2004, at 9:02:06
In reply to Straterra approval., posted by scoper on December 28, 2002, at 2:19:34
Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
Forest
Posted by Forest Gump on March 12, 2004, at 9:04:37
In reply to Re: New to Straterra, posted by dazed on February 4, 2004, at 12:00:20
I'm from Columbus area and I noticed they have a support group for adhd adults. Anyone ever been to a meeting? is it worth while?
Forest
Posted by Lightshifter on March 12, 2004, at 23:21:26
In reply to Re: Straterra approval., posted by Forest Gump on March 12, 2004, at 9:02:06
> Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> ForestIn reply Forest, I can say that indeed I had erectile dysfunction issues as well as urinary retention and difficult orgasms (anorgasmia i think its called). I have backed off to taking it only a couple of times a week and it seems to have helped.. For me, Strattera works for a very long time. I can go days and still feel as if I'm on the medication... perhaps my norepinephrine depletion isn't as bad as most. Maybe when I take it too often too much backs up and causes problems.
LightShifter
Posted by Cheraw on March 14, 2004, at 20:36:00
In reply to Re: Straterra approval., posted by Forest Gump on March 12, 2004, at 9:02:06
> Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> ForestForest,
I'm there with you, brother. Beyond the libido, orgasms are bizzare to say the least! Almost painful. I'm not sure this medication is worth all of the negative side effects. I haven't slept in days.
Posted by Forest Gump on March 15, 2004, at 7:58:55
In reply to Male Issues, posted by Cheraw on March 14, 2004, at 20:36:00
Okay, I'm not crazy then. Thanks for the reply. I mean this medication is great but my orgasiums are better. I may ask my doctor what he thinks I should do.
Posted by King Vultan on March 15, 2004, at 10:17:20
In reply to Male Issues, posted by Cheraw on March 14, 2004, at 20:36:00
> > Okay, I started out on this medication and it really calmed me down. However, I am constipated and my libido has went into the crapper. Anyone, having problems with erections? I know this is personal but I need to know. Thanks,
> > Forest
>
> Forest,
>
> I'm there with you, brother. Beyond the libido, orgasms are bizzare to say the least! Almost painful. I'm not sure this medication is worth all of the negative side effects. I haven't slept in days.
Based on my experiences last year with three tricyclics and Strattera, one thing I would suggest is considering adding an alpha-1 blocker, such as Hytrin or Flomax. This will tend to counteract the adrenergic agonist effects that NE reuptake inhibitors can have in the penis and prostate. My experience was that this improved erection quality and made ejaculation vastly more comfortable. You might also consider adding trazodone instead, which has a built in alpha-1 blockade and will also tend to counteract the insomnia problems you are experiencing.Beyond this, and as I've mentioned before, my experience was that desipramine had very similar therapeutic effects to Strattera and much fewer side effects. The insomnia was not nearly as bad, and desipramine also did not cause me drowsiness during the day. It was also much cheaper.
Todd
Posted by Forest Gump on March 17, 2004, at 8:55:32
In reply to Re: Male Issues » Cheraw, posted by King Vultan on March 15, 2004, at 10:17:20
Interesting, I'm not sure what all that means but its sounds as though my problem is with my medication. I really like the way I feel on Strattera however the sexually side effects frankly are not worth it. I'm hoping my doctor will have some suggestions when I see him for a follow up visit Monday.
Posted by New2Meds on March 21, 2004, at 10:07:11
In reply to 3 Stages of Strattera?, posted by liquidchakra on February 11, 2004, at 14:46:59
I have noticed that there isn't a lot of info out here about adults on this medicine. I have decided to post some of the experiences I have had on Straterra to hopefully generate some additional comments.
Posted by New2Meds on March 21, 2004, at 10:40:09
In reply to Adult Male on Straterra, posted by New2Meds on March 21, 2004, at 10:07:11
When I first started Straterra, the first few dats were very intense. I was told by my doctor to take 40mg for seven days and increase to 80mg. I guess my ADD was kicking in, because I ended up taking 80 mg for seven days and then decreasing to 40 mg...after a week on the 40mg dose, I went to my Dr. The Dr. was holding back a laugh I could tell but I suggested I try a 60mg dose and see how that worked.
Needless to say, when I initially started with the 80mg dose for a week I had several side affects.
Posted by spoc on March 21, 2004, at 12:57:15
In reply to Re: Adult Male on Straterra, posted by New2Meds on March 21, 2004, at 10:40:09
Hi New2Meds, I am not on Strattera but at the bottom of this I have pasted some very interesting dosing comments I came across, that I was going to check out further if I ended up trying it. I am an adult female and haven't tried all that many meds of any kind either. A pdoc recently put me on Ritalin based on a conversation only, and I suspect it's not agreeing with me and may not even be the class of meds I need, or at least by themselves. I thought of Strattera since I have seen mention that for some it has an anti-depressant effect too.
I didn't look into anything about the "standing" of the website I copied the following from, but the info on it seemed worth investigating. Note that the site author certainly shoots from the hip, which I like if credible too! He and his friend are patients at the Amen Clinic (haven't read the whole site, and don't know if he claims that all or part of his info derives from there). The site is called crazymeds.org:
-------
DOSAGE: ...This is where people get completely hosed with Strattera. This med can work wonders for more people if they and their doctors would just have some goddamn patience!!! The initial dosage is 18-25 mg. Got that? 18-25mg. Not 40mg. Not 60mg. 18-25mg. Unfortunately some bean counter in the bowels of Eli Lilly's accounting department determined that it was more profitable to restrict the size and number of 18mg and 25mg sample packs (only four capsules in each now), and let some people just fail with this med. So most of the sample packs sent out now are only 40mg capsules. It's more profitable for Lilly if Strattera doesn't work for everyone it could work for!! Isn't that crazy? Even the Amen Clinic where Mouse and I are treated gets very few of the 18mg and 25mg sample packs, and only because they treat kids! And they're in real tight with their Eli Lilly sales rep! Anyway, the highest an adult should start at is 25mg a day and just stay there for at least two weeks. Wait at least that long before going up to 40mg, and then only if it's going to make a big difference, not a small difference. Here's why - if you don't have enough norepinephrine to reuptake, Strattera starts going after MAO. And not in a good way, like an MAOI would. That is why people will feel wiped out when they take these outrageously high starting dosages. Then if they go back down to the previous dosage, they still feel crappy and give up. Well, it takes about two weeks to get over taking too much Strattera. Once again, have some freaking patience. Anyway, once you get past the 25mg a day barrier, dosages are as follows: 36-40 mg a day, 50 mg a day, 60 mg a day, 80 mg a day, 100 mg a day. Doses are usually divided between morning and afternoon, but some people get drowsy with Strattera, while others get hyper, so the dosing can be really flexible. I take my 40mg all in the morning.DAYS TO REACH A STEADY STATE: For all of the extensive pharmacokinetic testing Lilly did and data they published in Strattera's PI, far better than that done for most meds, they neglected to actually publish the steady state figures! I truly commend Lilly for its research. From reading the PI sheet you can tell they went above and beyond to get good data on any dosing differences required based on age, gender, ethnicity, taking Strattera with meals and trying to determine the difference between normal and poor metabolizers of the medication. However it looks like we've got information overload! With Strattera's wacky double metabolism (see half-life below) and identification of the poor metabolizer population, the numbers may be too variable to pin down a steady state. I couldn't find any number for it anywhere else.
========
> When I first started Straterra, the first few dats were very intense. I was told by my doctor to take 40mg for seven days and increase to 80mg. I guess my ADD was kicking in, because I ended up taking 80 mg for seven days and then decreasing to 40 mg...after a week on the 40mg dose, I went to my Dr. The Dr. was holding back a laugh I could tell but I suggested I try a 60mg dose and see how that worked. > > Needless to say, when I initially started with the 80mg dose for a week I had several side affects.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.